Objective  To investigate current status of infectious disease-specific health literacy (IDSHL) and its influencing factors among residents in three provinces of China, and to provide references for developing appropriate intervention strategies.

  Methods  Using stratified multistage random sampling, we selected 1 500 urban and rural citizens aged 15 – 69 years (including residents, senior high school students, hotel attendants, and construction workers) in each of the three provinces in northern, central and western China and conducted a self-administered survey among the citizens with Infectious Disease-Specific Health Literacy Scale between March and August 2015. T-test and one-way analysis of variance (ANOVA) were adopted in measurement data analysis and χ² test and logistic regression were used in enumeration data analysis to explore influencing factors of IDSHL.

  Results  For the 4 499 respondents, the mean IDSHL score was 21.69 ± 8.53 out of 38.62 and 73.4% of the respondents 6 were assessed with adequate IDSHL; the mean IDSHL domain scores were 6.96 ± 3.50 out of 13.17 for basic knowledge and concept on infectious disease, 6.84 ± 2.62 out of 9.96 for prevention of infectious disease, 3.80 ± 2.58 out 7.81 for management and treatment of infectious disease, and 4.09 ± 2.54 out of 7.68 for identification of infectious disease, respectively. The mean IDSHL score differed significantly among the respondents of different province, with the highest score for the respondents in Zhejiang province (23.13 ± 8.16), followed by the scores for the respondents in Hubei province (22.05 ± 8.38) and Gansu province (19.89 ± 8.70) (both P < 0.05). Multivariate logistic analysis showed that the IDSHL score was associated with age, education, sex, occupation, time spent on internet surfing per day, and self-reported health status. Binary logistic regression analysis revealed that the respondents with following features were more likely to have adequate IDSHL: at elder age (aged 25 years and above vs. aged 15 – 24 years: odds ratio OR = 1.613 – 2.111, 95% confidence interval 95% CI: 1.155 – 2.973), with higher education (senior high school/vocational school/technical secondary school and college/university vs. illiterate: OR = 2.801, 95% CI: 1.753 – 4.474 and OR = 7.100, 95% CI: 4.038 – 12.483), performing internet surfing (frequently vs. never: OR = 1.595 – 1.941, 95% CI: 1.282 – 2.472), reporting a good self rated-health (good vs. poor: OR = 3.029, 95% CI: 2.205 – 4.161), being students (yes vs. no: OR = 3.267, 95% CI: 2.066 – 5.164); while, compared to the female respondents and the respondents working as civil servants or personnel of public institutions, the male respondents and the respondents being farmers or workers without urban household registration were less likely to have adequate IDSHL (OR = 0.687, 95% CI: 0.589 – 0.801; OR = 0.686, 95% CI: 0.481 – 0.980).

  Conclusion  The infectious disease-specific health literacy is not at an adequate level and males, illiterates, workers, and non-internet users are major targeted populations for health education on infectious disease among Chinese residents.